{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:48:23Z","timestamp":1785941303994,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2025ZNSFSC1641"],"award-info":[{"award-number":["2025ZNSFSC1641"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study was undertaken to examine the associations between rapid eye movement (REM) sleep proportion, depressive and anxiety symptoms, and quality of life (QOL) in newly diagnosed epilepsy (NDE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 104 treatment\u2010naive people with NDE and 50 age\u2212\/gender\u2010matched healthy controls were enrolled. Assessments included polysomnography and the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C\u2010NDDI\u2010E), Generalized Anxiety Disorder\u20107, and Quality of Life in Epilepsy Inventory\u201031 (QOLIE\u201031). Eighty\u2010eight patients completed 12\u2010month QOL follow\u2010up. Cross\u2010sectional analyses included Spearman correlation and mediation (PROCESS Model 4, 5000 bootstraps). Longitudinal analyses used logistic and linear regression with sequentially added covariates, and least absolute shrinkage and selection operator for variable selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline REM sleep correlated negatively with C\u2010NDDI\u2010E (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>s<\/jats:italic>\n                      <\/jats:sub>\n                      \u2009=\u2009\u2212.512,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and positively with QOLIE\u201031 (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>s<\/jats:italic>\n                      <\/jats:sub>\n                      \u2009=\u2009.394,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). C\u2010NDDI\u2010E correlated negatively with QOLIE\u201031 (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>s<\/jats:italic>\n                      <\/jats:sub>\n                      \u2009=\u2009\u2212.461,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Depressive symptoms partially mediated the REM\u2013QOL association (indirect effect\u2009=\u2009.253, 52.5% of total effect). Anxiety did not mediate REM\u2013QOL but partially mediated REM\u2013depression. Longitudinally, the REM\u201312\u2010month QOL association was significant after adjusting for age and gender (odds ratio [OR]\u2009=\u20091.113,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.005), but not after additionally adjusting for baseline C\u2010NDDI\u2010E (OR\u2009=\u2009.968,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.542). No independent linear association remained (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u2009.087, 95% confidence interval = \u2013.119 to .292,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.405).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Reduced REM sleep is associated with increased depressive severity in NDE. Depressive symptoms mediate both cross\u2010sectional and prospective REM\u2013QOL associations, with little independent effect of REM sleep on QOL. Anxiety does not directly mediate REM\u2013QOL but partially mediates REM\u2013depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70413","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:05:17Z","timestamp":1785938717000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced rapid eye movement sleep proportion is associated with anxiety and depressive symptoms in newly diagnosed epilepsy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4053-7670","authenticated-orcid":false,"given":"Chao","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Neurology West China Hospital, Sichuan University  Chengdu China"},{"name":"Department of Geriatric and Neurology, West China School of Public Health and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5257-8099","authenticated-orcid":false,"given":"Ge","family":"Tan","sequence":"additional","affiliation":[{"name":"Mental Health Center, National Center for Mental Disorders West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8322-7355","authenticated-orcid":false,"given":"Junming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, West China School of Public Health and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1416-5938","authenticated-orcid":false,"given":"Honglei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology, West China School of Public Health and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7088-8642","authenticated-orcid":false,"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00225-2"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000237392.64230.f7"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107735"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864251325338"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2025.04.012"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007445"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038683"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17763"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101472"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13389"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0016570"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2012.11.001"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2022.07.016"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12772"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2025.06.002"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18112"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101416"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2017.02.013"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.784737"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201671"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2014.02.011"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6576"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.03.012"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.11.019"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1998.tb01278.x"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2010.07.012"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12499"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkae973"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-04154-0"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-021-01021-w"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12687"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-19898-5"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/epd2.20169"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17904"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.2006.04277.x"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41401-022-00918-2"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.10.006"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2012.10.001"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.106884"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-023-01060-1"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871527320666210618103344"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0330277"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:05:18Z","timestamp":1785938718000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":45,"alternative-id":["10.1002\/epi.70413"],"URL":"https:\/\/doi.org\/10.1002\/epi.70413","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"epi.70413"}}